Abstract
BACKGROUND: Horseshoe kidney tuberculosis (HSKTB) has been rarely reported. CASE PRESENTATION: We report the case of a patient who was thought to have prostatitis for 1 year, was later diagnosed with horseshoe kidney tuberculosis involving the right kidney and part of the isthmus. After consulting the surgical team, the patient chose to have laparoscopic heminephrectomy to remove the lesion and protect kidney function. He continued the 4-drug anti-tuberculosis (TB) regimen combined with antibiotics postoperatively. His body temperature peaked in the first 3 postoperative days and declined gradually from the 6 th day. After discharge, he continued anti-TB treatment at a specialized hospital, transitioning to a 2-drug regimen for one year. His body temperature returned to normal 2 months after the surgery, a delay potentially attributable to the severity of the pre-existing tuberculous infection and potential surgery-related tuberculous bacteremia. The patient subsequently returned for kidney stones, which facilitated follow-up. He reported no TB recurrence since then. CONCLUSION: This case underscores the feasibility of surgery with drug therapy for HSKTB. Sharing of such experiences can improve clinical decision-making for this rare condition.